Leading under pressure | Psychology of today

“You are a surgeon. What should we do?”

The energy in the operating room was tense. As an ophthalmologist, I was preparing to perform cataract surgery with an increasingly frail older gentleman. I’m worried Under mild sedation. He was moving and could not lie yet. The nurse looked at me. “Can I even move on?”

I felt the vortex of uncertainty had risen. Cancellation means delays that could lead to worsening vision loss in this patient. This could have a deep impact on his independence and quality of life. Progress took its own risk. In microsurgery, we operate through a microscope. Here, even the slightest movement of the patient, all micrometers appear to be at risk and earthquakes in the surgical field.

I took a deep breath and exhaled slowly. Instead of escaping the moment, enter with clear and calmness. I knew I had the expertise to manage what was being deployed. And when I chose to maintain ground, I was able to be stable not only with my hands, but also with the teams around me.

And we did. It wasn’t easy, but we worked together, adapted, and successfully completed the surgery.

Or, pressure is expected, but the mental sacrifice it takes is not inherent to the medicine. Whether you are making time-sensitive decisions during surgery, leading important moments to others, or managing a crisis in the boardroom, you can still have an internal high stakes experience. leadership You can feel that they are surprisingly similar.

If you are in a leadership role – whether you are a healthcare professional, an executive, or someone else is leaning on you – you are likely to face a moment like this.

Pressure is built. All eyes are on you. And somewhere under the surface, your brain begins to compete: What would you do if you made this wrong? What would you do if something lies down? What happens if this falls apart?

This is where leadership becomes more than strategy.

That will be Self-regulation.

Why lead under pressure feels so intense

In high stakes moments, our nervous system does exactly what they are designed to do. Respond to perceived threats. This might look like this:

• Responsiveness instead of intentional behavior.
• Mental mist or decision paralysis.
• Irritability, self-doubt, or withdrawal.

We often think that the solution is just to push, but that makes us react. The truth is that we need to Train our brains Be clear, even when pressure is high.

So… how do you leave it grounded?

In my job as a surgeon who is an award-winning medical educator and national advocacy leader, I have experienced a significant proportion of high pressure moments. I also had the privilege of leading experts across the sector, including complex systems, people who demand requests and work to guide themselves and others through emotionally charged decisions.

Over time I realized that I don’t necessarily know any more leaders who thrive under pressure.

They developed the ability to simply stay Currently emotionally regulated and values When that’s the most important thing.

That doesn’t mean it’s easy. But that is possible.

Here are three strategies that helped me and the leaders I support to make that shift:

1. Name it to tame

When pressure collides, our emotional brains, especially the amygdala, can take over the ability to clearly think. One simple but powerful tool is name Feelings You feel it.

• “I’m overwhelmed.”
• “I feel exposed.”
• “I’m frustrated.”

This is the first step in what I call 3RS –Reflect, reconstruct, respond– A Neuroscience– An informed framework I developed to help leaders self-regulate in real time.

By naming what you feel, you reduce emotional strength and create space for you to choose how to move forward.

2. Reconstruct the story

Our brains respond not only to events alone, but to how we interpret them.

Under pressure, it’s easy to fall Cognitive distortion– Automatic, often useless thinking patterns that tend to exaggerate fear Or negative consequences:

• “They don’t respect me so they’re asking me questions.”
• “If we don’t handle this completely, we’ll lose their trust.”

Reframing allows you to challenge those stories and replace them with something more useful.

• “They may not be against me, they may be passionate about the outcome.”
• “This is a moment that requires calmness, not perfect.”

This does not mean denial of reality. That means choosing the perspectives you support Clarity to Chaos.

3. Leading from core values

This is the anchor.

Pause and ask before responding to a high pressure moment. Who do you want to be at this moment?

Make your answer your tone, your words, and your existence guide.

It’s your leadership compass when emotions want to take the wheel, whether courage, compassion, calm.

Ripple effects of regulated leadership

This is one of the most powerful truths about leading under pressure. Your presence creates ripples.

• If you lead clearly, others feel safer.
• Responding with calmness makes others more likely to maintain ground.
• When modeling Emotional regulationyou give your team permission to do the same.

This concept of influence through existence is something I explored. Rippling Effect: How Leadership Begins– Posts that resonate with thousands of readers.

That’s a reminder Emotional intelligence It’s not software. It’s strategic.

And when you practice under pressure, it becomes a superpower.

You don’t have to be perfect – just exist

Often, we believe that leading well under pressure always means having the right answer. But what people often need most is that we are It’s transparent, calm and connected.

Even when you don’t know.

Even when it’s difficult.

Even when your voice is shaking a little.

It doesn’t have to be perfect under pressure.

You just need to be.

Author’s Notes:

This work has been adopted from my future works. Lead under pressureit connects neuroscience, emotional things Intelligenceand lived my leadership experience into my two unique frameworks: admit and 3rs.

If this post resonates with you, I encourage you to reflect on how you will manifest at key moments. And with the right tools, you know that clarity under pressure is always in the range.